Anna Teresa Palamara

La Microbiologia dalla diagnostica alla ricerca

ROMA, 23 GENNAIO 2020

“There is probably no chemotherapeutic drug to whichin suitable circumstances the bacteria cannot reactby in some way acquiring ‘fastness’ [resistance].”—Alexander Fleming, 1946

First report on antibiotic-resistance

Consumo di antibiotici

Ambiente nosocomiale Tra la popolazione In agricoltura

Standard methods and Rapid Diagnostic Tests in Sepsis

(< 1 h)

(12-24 h)

ID: 24 h from positivity

AST: 48 h from positivity

L’innovazione tecnologica può essere efficace solo se inserita nel giusto modello organizzativo

L’accorciamento dei tempi di diagnosi, deve tener conto dellenumerose variabili che rendono ogni laboratorio diversodall’altro:

• Personale

• Turni di apertura

• Parco tecnologico e reali possibilità applicative

• Sensibilità e disponibilità del management sanitario

• Sensibilità e disponibilità del personale sanitario

• …..........

Medical Microbiology and Infection Prevention University Medical Center GroningenNetherlands

Il modello olandese

AntimicrobialStewardship (A-Teams)

Team

DiagnosticStewardship

InfectionPreventionStewardship

Dik et al. 2015 Future MicrobiologyZingg et al. 2015 CMI

ID doctor

Clinicalmicrobiologists

microbiologicaltechnician Infection Control

Practitioner

Clin. Pharmacist

Whoever I forgot CM HygieneMolecular Biologists/informatician

PHO

Theuretzbacher et al. Nat Rev Microbiol. 2019

The global preclinical antibacterial pipeline

MAC-545496

DAROBACTIN

Educate the clinicians for appropriate antibiotic prescribing

Education

About 50% of the antibiotic prescriptions, both in the community and in hospitals, can be considered

inappropriate (inadequate dosing and wrong duration)

Lee et al. Int J Environ Res Public Health. 2013

Educate patients, children (e.g., through schools and day care), the public, and other relevant healthcare professionals (e.g., primary-care staff, pharmacists, dentists and medical students) regarding prudent antibiotic prescribing and personal hygiene (e.g., handwashing)

SUPERBATTERI:Quel che non uccide rende resistenti

STEFANIA STEFANIANNA TERESA PSLSMARACECILIA AMBROSIDANIELA SCRIBANO